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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Procedure

Tibial Nerve Stimulation

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Immediate
Success rate
60-80%
Recurrence
Variable

What it is

What is Tibial Nerve Stimulation?

Percutaneous Tibial Nerve Stimulation (PTNS) is a minimally invasive, office-based form of neuromodulation used to treat fecal incontinence. The procedure involves placing a fine needle electrode near the tibial nerve in the ankle. This nerve contains fibers originating from the same spinal root (S3) that innervates the pelvic floor and sphincter muscles. The electrode is connected to a small external stimulator that delivers a mild electrical current, which travels up the tibial nerve to the sacral nerve plexus. This stimulation is thought to modulate the nerve pathways that control rectal and sphincter function, leading to improved continence.

Am I a candidate?

Who is a Good Candidate for Tibial Nerve Stimulation?

PTNS is an ideal treatment for patients with mild to moderate fecal incontinence who have failed conservative management with diet, fiber, and medications, and who wish to avoid more invasive therapies like sacral nerve stimulation. It is a good option for patients who are not surgical candidates or who have had an inadequate response to pelvic floor physical therapy. It can be used for patients with or without a sphincter defect and is effective for both urge and passive incontinence.

Recovery

What is the Recovery Like?

There is no recovery time needed after a PTNS session. Patients can immediately resume all normal activities, including driving. The treatment protocol typically involves an initial course of 12 weekly 30-minute sessions in the office. Patients who respond to the initial course may then continue with maintenance therapy, with sessions spaced out every few weeks to months, to sustain the therapeutic benefit.

Risks & considerations

What are the Risks?

Tibial nerve stimulation is an extremely safe procedure with a very low risk of side effects. The most common issues are related to the needle placement and are typically mild and transient. Risks include:

  • Pain or Discomfort: Mild discomfort or a tingling sensation at the needle site during stimulation is common.
  • Bruising or Bleeding: A small amount of bruising or bleeding at the needle insertion site can occur.
  • Local Skin Inflammation: Minor redness or irritation at the needle site is possible.
  • Nerve or Tendon Injury: Injury to the tibial nerve or a nearby tendon is a theoretical but very rare risk.

There are no known long-term or serious complications associated with this therapy.

Sources

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